Hello! - My TRT Journey

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trtnoobie

New Member
Background

I'm 32, 5'10, and at around 30 my libido tanked. I didn't notice at first because with an ex-wife, a kid, a girlfriend, a job, etc... I'm a busy guy, so not having sex as often didn't really register too high on my list of shit to care about (though it was definitely taking a toll on my new relationship). A little over a year ago I was playing a lot with my son one weekend, tossing him around and such, and my back was sore the next day. I thought this sucks, I don't want to have trouble keeping up with him because of my poor health, so I decided to get serious about making some improvements. At this point I weighed about 210lbs and probably around 30% bf.

I had dabbled in the gym before with friends, but never consistently and never with any real attention to diet. I got serious about my diet and exercise and I definitely made some improvements, both in how I looked and how I felt, but after the first few months of noobie body recomposition, things seemed to stall. I managed to get down to around 185lbs and maybe 20-25% bf. I started doing more research and came across low T, then suddenly things clicked. The libido, the way I've felt "less than myself" the last few years, and my lackluster gym gains or fat loss (past the initial few months) made sense. In the first ~3-4 months at the gym I got my squat to ~250, bench to ~180, deadlift to ~280. Now, after a year of lifting, I'm at around 265/195/300.

Starting TRT

In March, I went to an endocrinologist who did blood work. This was in the morning, and I came back with overall good health except I was low on vitamin D, SHBG 34, Free Test 6.7, Total Test 315. What did the endo say? "Maybe a vitamin D supplement will help.". In April, I found a urologist who did his own blood work which came back very similar and he agreed I was a candidate for TRT. He started me on 150mg/wk Test-cyp. I've done 6 injections so far, on Wednesdays. Between 5 and 6 (on a Friday) we did blood work again, in the morning, and came back with SHBG 18.9, Free Test 14.7, Total Test 720.

The first few shots didn't seem to do much, but after shot 3 or 4 I started to notice some more libido on Friday/Saturday (remember, I inject on Wednesdays). After shot 5 I noticed my libido was good from about Thursday to early on Sunday. I'm hopeful that this week's shot #6 will see me through the weekend.

Now What?

As TRT continues, I hope my libido can be consistently good and my relationship and outlook on life in general continues to improve. I do want to have another child in the next ~3-5 years, so once we've stabilized my dosage I'm going to talk to the urologist about when and how to add HCG to my protocol to preserve sperm production. And I hope that now that my testosterone is in normal range I can get back to making progress in the gym, because it was nice to start getting some compliments after the first few months.

It seems there is so much to learn, and so much information out there that doctors may not be up to date on. I really appreciate this site as it seems to be a great resource of knowledgeable people. Thanks, guys!
 
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CoastWatcher

Moderator
Welcome to Excelmale. Why test when you did? There's no question that the appropriate time to test levels is prior, just prior, to your injection. I bet, with your low SHBG, your trough, your level just before a shot, will be low...possibly very low. Splitting your dose into two injections every 3.5 days is common practice, particularly with low SHBG in the picture. It also avoids estradiol spikes. Which makes me wonder what your estradiol level is?
 

trtnoobie

New Member
My doctor wanted to test either Friday or Monday, and I couldn't get off work to test on Monday. I figured that meant I'd get a reading higher than my trough, but as we're still stabilizing my levels I assumed I'd do the next test at my trough.

The test had my estradiol at 42. Is that too high? I've read about splitting my dosage to twice a week for helping estradiol management and thought I'd consider that once I'm self-administering (should be after 1-2 more visits). I figured if I was able to inject just once a week and my readings were okay I would stick to that.
 

CoastWatcher

Moderator
My doctor wanted to test either Friday or Monday, and I couldn't get off work to test on Monday. I figured that meant I'd get a reading higher than my trough, but as we're still stabilizing my levels I assumed I'd do the next test at my trough.

The test had my estradiol at 42. Is that too high? I've read about splitting my dosage to twice a week for helping estradiol management and thought I'd consider that once I'm self-administering (should be after 1-2 more visits). I figured if I was able to inject just once a week and my readings were okay I would stick to that.

Was your estradiol tested with the correct test, the sensitive/ultrasensitive, LC, MS/MS assay? It's climbing. Was your thyroid fully evaluated prior to treatment? Please provide reference ranges for test as every lab establishes their own upper and lower range.

It it is very important to test at trough, particularly with low SHBG potentially playing a role in your efforts.
 

trtnoobie

New Member
I don't know what test was used, and I'm not sure what a full thyroid evaluation would be. The endocrinologist and urologist both just did blood tests. I'll post my test results.
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JMP

Member
trtnoob, that is almost definitely not the sensitive Estradiol test. You should request the sensitive next time to get a more accurate picture. If I had to take a wild guess and that's what it would be, I would suspect your sensitive test would be in the low to mid 30's which for many works pretty well for libido and lack of e2 side effects. Since your shbg is now around 19 I agree that an every 3.5 day injection schedule would benefit you more than 1x per week. Mine pre-trt was 22 and I am on a m/w/f schedule that seems (its only been a month) to be working well so far. With that said, your shbg started much higher so maybe every 3.5 days will work great. Finally if it hasn't been said already, your trough will be found by testing the morning before your next injection (wed. morning pre-shot). As coast said, testing in the trough is going to show a lower number, maybe quite a bit lower. Good luck getting dialed in and remember to be patient and make one change at a time, give it 5-6 weeks then test again before changing anything else.
 

trtnoobie

New Member
TRT and remaining fertile can be hard, at your young age my want to use Clomid instead of testosterone.
You could as try a restart

Vince, that's kind of the plan. Once we've got my levels looking good and I'm feeling good, the doctor wants to try switching to clomid. He warned me though, that most guys seem to prefer the shots once they've felt good from those and try switching to clomid.
 

CoastWatcher

Moderator
Vince, that's kind of the plan. Once we've got my levels looking good and I'm feeling good, the doctor wants to try switching to clomid. He warned me though, that most guys seem to prefer the shots once they've felt good from those and try switching to clomid.

I don't understand your doctor's logic. Why not try Clomid now, a full restart protocol, prior to the introduction of exogenous testosterone? Putting you on TRT means a full suppression of your HPTA axis. It will be even harder to achieve success with Clomid at that point. His plans are not in your best interests.
 

trtnoobie

New Member
When we talked about clomid, he didn't mention the option of using it to restart anything (ie. it would have been a daily pill for life instead of weekly injections for life). Given those options, I figured I would try injections first to realize the benefits more quickly and then try switching to clomid.

I'd seen a second endocrinologist between the first one and this urologist, and they also told me there was nothing they could do for me. From what I've learned since starting TRT, it does seem that my doctor is not the best out there, but he's open to discussions and I was happy to see someone who would actually do something about my levels rather than tell me I was normal with the T of an 85 year old man at 32. I'm hoping with this doctor and the help of members of this forum I can get a good protocol working.

It's Monday morning after my 6th Wednesday shot and I feel like I finally am at a T level where my weekend is good. I had the energy to play with my son, go out with him and the girlfriend for dinner, buy the girlfriend some fun clothes while we were out and then get home and, well, actually WANT to enjoy that purchase with her ;). It sounds like I should talk to the doctor about whether a clomid restart is possible, but I really don't want to let go of what I've gotten back. How long am I looking at trying a restart before knowing whether or not it will work?
 

trtnoobie

New Member
A correction to what I said before (I don't think I can edit the original post): The doctor gave me 150mg for the first two shots, but 100mg each week since then. So, 2@150mg, and then 5@100mg.

Well, I just got back from my appointment and 7th shot. We spoke about the clomid restart and he said he's happy to try this with me. He wrote me a prescription for 30 pills (a 2 month supply @ EOD dosage) along with a prescription for 1 10ml vial of Test-cyp for me to begin injecting myself.

The idea is that I'll continue with just Test-cyp until I still feel I have good libido right before a shot, and then I'll begin reducing the dosage and taking clomid. We're doing blood work in again two months to see where I am.
 

CoastWatcher

Moderator
A correction to what I said before (I don't think I can edit the original post): The doctor gave me 150mg for the first two shots, but 100mg each week since then. So, 2@150mg, and then 5@100mg.

Well, I just got back from my appointment and 7th shot. We spoke about the clomid restart and he said he's happy to try this with me. He wrote me a prescription for 30 pills (a 2 month supply @ EOD dosage) along with a prescription for 1 10ml vial of Test-cyp for me to begin injecting myself.

The idea is that I'll continue with just Test-cyp until I still feel I have good libido right before a shot, and then I'll begin reducing the dosage and taking clomid. We're doing blood work in again two months to see where I am.

So...you're going to totally shut down your natural production of testosterone with injections, and then turn around, stop the injections, and try and restart the HPTA axis? Why not see if Clomid will work now? This is very puzzling.
 

trtnoobie

New Member
So...you're going to totally shut down your natural production of testosterone with injections, and then turn around, stop the injections, and try and restart the HPTA axis? Why not see if Clomid will work now? This is very puzzling.

The idea is that if I can keep some of the lifestyle improvements from higher T via injections, while trying clomid to help my natural production, that's preferable to cutting off the injections and having my T plummet again while we wait for clomid to work or not. Is this not sound?
 

trtnoobie

New Member
Bump. Is the current plan not a good idea? I'm really hesitant to drop the injections and feel like crap again, but if it's the only way clomid might work I might just have to take the hit for a few months to give it a try.
 

JMP

Member
This doesn't make sense to me. I agree with CW that there is no reason to continue the T and then start Clomid later. If you are going to do this you should stop t now, wait a week or two then start the Clomid. The Clomid will most likely not be effective until some of the residual t is out of your system. You could start the Clomid upon stopping the T but I don't think it will be effective until exo test leaves the body. At your age there is nothing wrong with trying a restart but no reason to continue T for now if that's the direction you choose.
 

CoastWatcher

Moderator
The idea is that if I can keep some of the lifestyle improvements from higher T via injections, while trying clomid to help my natural production, that's preferable to cutting off the injections and having my T plummet again while we wait for clomid to work or not. Is this not sound?
No, this isn't sound.

Exogenous testosterone is going to shut down all natural testosterone production. That's what happens on TRT. If the use of Clomid is being considered, to restart your body's natural production, the time to do it is before you travel the road of exogenous TRT. Clomid first, evaluate, determine if success has been achieved. If so - wonderful. If not - TRT.

As I wrote, why shut down your HPTA axis only to then try and restart it?
 

trtnoobie

New Member
I see. Then I guess I have a decision to make.

A) Stop the T now, wait two weeks, try a clomid restart (better chance of future kids, no T dependence)
B) Commit to T injections for life (more stable and probably higher levels of T, better body composition probably)

At 32, with one kid already, this is tough.

And another decision: Is this worth finding a new doctor? Ugh.
 

CoastWatcher

Moderator
I see. Then I guess I have a decision to make.

A) Stop the T now, wait two weeks, try a clomid restart (better chance of future kids, no T dependence)
B) Commit to T injections for life (more stable and probably higher levels of T, better body composition probably)

At 32, with one kid already, this is tough.

And another decision: Is this worth finding a new doctor? Ugh.

Finding a new doctor should be your first order of business. Your current physician fundamentally misunderstands how to manage a protocol. A Clomid protocol requires as much, if not more, understanding of male hormones as a TRT protocol does. One wouldn't take a car to a mechanic who "sort of" grasped the essentials of the fuel injection system. Why would you trust your body and health to someone who was "sort of" up to speed on male hormones?

What has been said about HCG during TRT as an adjunctive medication to maintain testicular vitality? It may not be a zero-sum, all of nothing game in regard to fertility?
 

trtnoobie

New Member
While I decide what to do... is there any value at all in filling my clomid prescription if I end up not trying for a restart? I was supposed to pick it up today, but it's not covered by insurance, so I'd rather not if I won't be using it.
 

CoastWatcher

Moderator
While I decide what to do... is there any value at all in filling my clomid prescription if I end up not trying for a restart? I was supposed to pick it up today, but it's not covered by insurance, so I'd rather not if I won't be using it.
I'd put it in a safe place and act on it when you know what course of action to follow.

By the way, what was said about HCG as an effort to keep fertility (and other things) in the picture? How much HCG is being prescribed?
 
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